Germany Staying Healthy

Common sense is the simplest prescription for good health while you travel. Drink lots of fluids to prevent dehydration and constipation and wear sturdy, broken-in shoes and clean socks. Germany enjoys a fairly temperate climate and relatively safe landscape, so day-to-day activities might not seem taxing. The stress of traveling can take its toll, however, and you should always be mindful of your mental and physical wellness.

Environmental Hazards

Hypothermia and frostbite: A rapid drop in body temperature is the clearest sign of overexposure to cold. Victims may also shiver, feel exhausted, have poor coordination or slurred speech, hallucinate, or suffer amnesia. Do not let hypothermia victims fall asleep. To avoid hypothermia, keep dry, wear layers, and stay out of the wind. When the temperature is below freezing, watch out for frostbite. If skin turns white or blue, waxy, and cold, do not rub the area. Drink warm beverages, stay dry, and slowly warm the area with dry fabric or steady body contact until a doctor can be found.
High Altitude: Allow your body a couple of days to adjust to reduced oxygen before exerting yourself. Alcohol is more potent and UV rays are stronger at high elevations. This is particularly relevant to the mountainous regions of Germany.

Insect-Borne Diseases

Many diseases are transmitted by insects—mainly mosquitoes, fleas, ticks, and lice. Be particularly aware of insects as you travel in wet or forested areas, especially while hiking and camping. Wear long pants and long sleeves, tuck your pants into your socks, and use a mosquito net. Use insect repellents that contain DEET and soak or spray your gear with permethrin (licensed in the US only for use on clothing). Ticks—which can carry Lyme and other diseases—can be particularly dangerous in rural and forested regions, especially throughout Central and Southern Germany, including the Harz Mountains, the Black Forest, and the Alps. Always check yourself for ticks after a day spent in the outdoors.

Tick-borne encephalitis: A viral infection of the central nervous system transmitted by tick bites (primarily in wooded areas during the summer) or by consumption of unpasteurized dairy products. The risk of contracting the disease is relatively low, especially if precautions are taken against tick bites.
Lyme disease: A bacterial infection carried by ticks and marked by a circular bull’s-eye rash of 2 in. or more. Later symptoms include fever, headache, fatigue, and aches and pains. Antibiotics are effective if administered early. Left untreated, Lyme can cause problems in joints, the heart, and the nervous system. If you find a tick attached to your skin, grasp the head with tweezers as close to your skin as possible and apply slow, steady traction. Removing a tick within 24hr. greatly reduces the risk of infection. Do not try to remove ticks with petroleum jelly, nail polish remover, or a hot match. Ticks usually inhabit moist, shaded environments and heavily wooded areas. If you are going to be hiking in these areas, wear long clothes and DEET.

Food- And Water-Borne Diseases

Prevention is the best cure: be sure that your food is properly cooked and that the water you drink is clean. Watch out for food from markets or street vendors that may have been cooked in unhygienic conditions. Other culprits are raw shellfish, unpasteurized milk, and sauces containing raw eggs. As in many European countries, German natives avoid drinking much tap water, preferring often sparkling Mineralwasser. Nevertheless the tap water is potable. If in doubt, buy bottled water or purify your own water by bringing it to a rolling boil or treating it with iodine tablets. (Boiling is more reliable.)

Traveler’s diarrhea: Results from drinking fecally contaminated water or eating uncooked and contaminated foods. Symptoms include nausea, bloating, and urgency. Try quick-energy, non-sugary foods with protein and carbohydrates to keep your strength up. Over-the-counter anti-diarrheals (e.g., Imodium®) may counteract the problem. The most dangerous side effect is dehydration. Drink 8 oz. of water with ½tsp. of sugar or honey and a pinch of salt, try uncaffeinated soft drinks, or eat salted crackers. If you develop a fever or your symptoms don’t go away after 4-5 days, consult a doctor. Consult a doctor immediately for treatment of diarrhea in children.
Hepatitis A: A viral infection of the liver acquired through contaminated water or shellfish from contaminated water. Risk of infection is low in Germany, but a recent outbreak among tourists drinking orange juice raised concern. Symptoms include fatigue, fever, loss of appetite, nausea, dark urine, jaundice, vomiting, aches and pains, and light stools. The risk is highest in rural areas but is is also present in urban areas. Ask a doctor about the Hepatitis A vaccine or an injection of immune globulin.
Giardiasis: Transmitted through parasites and acquired by drinking untreated water from streams or lakes. Symptoms include diarrhea, cramps, bloating, fatigue, weight loss, and nausea. If untreated, it can lead to severe dehydration. Giardiasis occurs worldwide.
Leptospirosis: A bacterial disease caused by exposure to contaminated water or soil. It is most common in tropical climates but has been found in large German cities. Symptoms include a high fever, chills, nausea, and vomiting. If not treated it can lead to liver failure and meningitis. There is no vaccine. Consult a doctor for treatment.

Other Infectious Diseases

The following diseases exist all over the world. Travelers should know how to recognize them and what to do if they suspect they have been infected.

Hepatitis B: A viral infection of the liver transmitted via blood or bodily fluids. Symptoms, which may not surface until years after infection, include jaundice, appetite loss, fever, and joint pain. It is transmitted through unprotected sex and unclean needles. A 3-shot vaccination sequence is recommended for sexually active travelers and those planning to seek medical treatment abroad and must begin 6 months before traveling.
AIDS and HIV: For detailed information on Acquired Immune Deficiency Syndrome (AIDS) in Germany, call the 24hr. National AIDS Hotline at ☎+1-800-342-2437. Germany screens incoming travelers for AIDS, especially those planning on extended visits for work or study, and denies entrance to those who test HIV-positive. Contact the consulate of Germany for more information.
Sexually transmitted infections (STIs): Gonorrhea, chlamydia, genital warts, syphilis, herpes, HPV, and other STIs are easier to catch than HIV and can be just as serious. Though condoms may protect you from some STIs, oral or even tactile contact can lead to transmission. If you think you may have contracted an STI, see a doctor immediately.

Other Health Concerns

Medical Care On The Road

If you are concerned about obtaining medical assistance while traveling, you may wish to employ special support services. The MedPass from GlobalCare, Inc., 6875 Shiloh Rd. East, Alpharetta, GA 30005, USA (☎+1-800-860-1111; www.globalcare.net) provides 24hr. international medical assistance, support, and medical evacuation resources. The International Association for Medical Assistance to Travelers ( IAMAT; US ☎716-754-4883, Canada 519-836-0102; www.iamat.org) has free membership, lists English-speaking doctors worldwide, and offers detailed information on immunization requirements and sanitation. If your regular insurance policy does not cover travel abroad, you may wish to purchase additional coverage .

Travelers with medical conditions (such as diabetes, allergies to antibiotics, epilepsy, or heart conditions) may want to obtain a MedicAlert membership (US$40 per year), which includes among other things a stainless-steel ID tag and a 24hr. collect-call number. Contact the MedicAlert Foundation International, 2323 Colorado Ave., Turlock, CA 95382, USA (from US ☎888-633-4298, outside US +1 209-668-3333; www.medicalert.org).

Women’S Health

Women traveling in unsanitary conditions are vulnerable to urinary tract infections, including bladder and kidney infections. Bring supplies from home if you are prone to infection, as they may be difficult to find on the road. Tampons, pads, and contraceptive devices are widely available, though your favorite brand may not be stocked so bring extras of anything you can’t live without. First-trimester abortion is legal in Germany, but in order to get one, a woman must undergo counseling and a three-day wait. Contact PRO FAMILIA Bundesverband (a family parenthood group; www.profamilia.de) or the state-supported BZgA (www.familienplanung.de).